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American Medicine
In the Presidential debates, and in every newspaper, we are hearing contrasts between the medical care programs of President Obama versus Governor Romney. What is good or bad for you individually?
Healthcare reform is a very big issue and directly affects your personal care. Many of these reforms are discussed in my new book Surviving American Medicine, but here are a few conclusions which I have drawn which may help you to overcome your fears of healthcare reform.
Obama-care (officially known as the Patient Protection and Affordable Care Act) has several very good points. By eliminating pre-existing condition exclusions, eliminating rescission (cancellation of your insurance if you develop an illness), eliminating lifetime caps or maximums on health insurance payments, and including coverage of preventive medicine, ObamaCare delivers some very beneficial improvements. In addition, by guaranteeing coverage of clinical trials (already guaranteed that many states and by Medicare) and by allowing children to remain on a parents’ health plan until age 26, there are changes in healthcare insurance which are favorable.
Medicare drugs may also be cheaper on Part B plans, and undoubtedly more people are covered with health insurance through an expanding Medicaid program. Mandating use of electronic health records by your doctor may have a major benefit in getting more efficient care.
So, is anything bad about Obama-care? Many patients will not be able to keep their own physicians since many physicians (estimated by some health analysts to be as high as 60%) may not participate in some private health plans, healthcare exchanges or the Medicare program after physician payments are reduced. Furthermore, all care will be more closely managed in order to make certain that insurance companies can remain profitable (this may cause you to have more denials of authorizations for tests or treatments). The Independent Payment Advisory Board (IPAB), which will be formed by 2014, will undoubtedly have an impact in decreasing availability of some tests or treatments.
PPO insurance costs have already begun to increase, and Medicare will have fewer programs available for patients. The physicians will have less input into actual management of your care. Big question marks remain regarding how health exchanges will operate, whether or not Accountable Care Organizations (ACOs) will be successful in helping your care, and the verdict on these programs will be out for several years. Nonetheless, many of the good elements of Obama-care need to be retained even if other parts of the law are amended, delayed, or even repealed.
So what are the conclusions with regard to Romney-care? Good points are more choices for different types of insurance, especially if insurances are allowed to be sold across state lines. There will be more money available within Medicare which will preserve access to needed tests and treatments. There will be no IPAB committee (largely composed of non-physicians) to be ultimately restricting benefits on Medicare. PPO insurance will be more affordable, more employers will be providing insurance, and patients who have continuous coverage will be protected against pre-existing exclusions. More people will be able to keep their own doctors, and there may be fewer requirements to change hospital care. However, bad parts of the Romney agenda are that this will be slow in changing since changes will need bipartisan support within congress. There is a high likelihood that the Romney plan will be modified as things go forward.
So what is good or bad for you?
You must be prepared to see your physician change, possibly requiring you to find a new physician or new specialist. Also, you may have to get new insurance. Following the tips in my new book Surviving American Medicine can give you solutions to those problems.
The most important tip for you is to follow the changes in laws and regulations very carefully, since they may dramatically affect your care. Stay tuned to this blog for changes as they occur.
